NPI | 1902458870 |
---|---|
Former Name | MADISON E RICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA13724) |
Additional Taxonomies | 231H00000X Audiologist (Licence: TN 1948) |
Enumeration Date | 2019-07-11 |
Last Update Date | 2023-01-19 |